Recommendation 9
➤ During pregnancy, we suggest against routine 25(OH)D testing. (2|
⊕
)
Technical remarks:
• In this population, 25(OH)D levels that provide pregnancy outcome-specific benefits
have not been established in clinical trials.
• The panel suggests against (a) routine screening for a 25(OH)D level to guide decision-
making (i.e., vitamin D vs no vitamin D) and (b) routine follow-up testing for 25(OH)
D level to guide vitamin D dosing.
• This recommendation relates to generally healthy pregnant individuals who do not
otherwise have established indications for 25(OH)D testing (e.g., hypocalcemia).
Adults With Prediabetes (By Glycemic Criteria)
Recommendation 10
➤ For adults with high-risk prediabetes, in addition to lifestyle modification, we
suggest empiric vitamin D supplementation to reduce the risk of progression
to diabetes. (2|⊕⊕⊕
)
Technical remarks:
• Lifestyle modification must be a routine management component for adults with
prediabetes.
• The clinical trials informing this recommendation primarily related to adults with
high-risk prediabetes, identified as meeting two or three American Diabetes Association
glycemia criteria ( fasting glucose, HbA1c, 2-hour glucose after a 75-gram oral glucose
challenge) for prediabetes and those with impaired glucose tolerance.
• In the clinical trials included in the SR, the vitamin D doses ranged from 842 to 7543
IU (21 to 189 μg ) daily equivalent. The estimated weighted average was approximately
3500 IU (88 μg ) per day. Participants in some trials were allowed to remain on their
routine supplements, including up to 1000 IU (25 μg ) of vitamin D daily.
Dosing
Recommendation 11
➤ In adults ages 50 years and older who have indications for vitamin D
supplementation or treatment, we suggest daily, lower-dose vitamin D instead
of non-daily, higher-dose vitamin D. (2|
⊕⊕
)
Technical remark:
• The panel did not identify evidence related to individuals younger than age 50 years.
